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Herpes Simplex Virus Meningitis Since Armstrong isolated herpes simplex virus from a patient with aseptic meningitis in 1943, clinicians and virologists have been looking for further cases of this condition. In spite of much improved laboratory techniques during recent years the diagnosis has been made relatively infrequently by serological tests in the United Kingdom, and the virus has been isolated rarely in comparison with the frequency with which a firm diagnosis of meningitis due to mumps and enteroviruses has been established.

7) or an unrecognized lesion as Knox (1968) pointed out. It is probable that the infection is acquired for example from a parent or sibling with recurrent cold sores who kisses the child, or from a nurse who may spread the infection in a nursery through inadequate attention to details of hygiene. The special problems of neonatal herpes simplex infections are described on p. 69. Herpes simplex gingivo-stomatitis is not uncommon among young adults. During the five-year period October, 1964-October, 1968 we have seen 18 young adult patients with this complaint among our students in the Oxford Medical School, and the nurses and technicians in the United Oxford Hospitals (out of about 150 students, and about 750 nurses and technicians at risk).

These antibodies are also qualitatively different when they appear after the primary attack from those present later; those to the soluble antigen are heat labile and more antigen is required for their detection. Sometimes only anti-V antibody can be detected in the first attack. After repeated subclinical reactivation or recurrences of the lesion the antibodies for V and S become stabilized, usually at a titre Herpes Simplex 29 comparable to that of the neutralizing antibody. However, as in all virus infections the complement-fixing antibodies may wane with time if recurrences become infrequent or cease, as for example in the patient with trigeminal neuralgia mentioned above.

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